Comments on: Interruptions when doctors see patients and how that affects care

By: Doc Stone

Doc Stone — Wed, 21 Oct 2009 00:03:47 +0000

As I entered middle age, I found that controlling the flow of flow of information was key to doing quality work. Whether it was wisdom of experience or the the beginning of cognitive decline remains to be seen. Strictly controlling interruptions in and out of the workplace is critical for me to maintain the quality of my work and of my life. That naturally means not being instantly available to everyone all the time. Finishing this patient, this file, this conversation, this meal, this nap, before entertaining the next demand on my time is essential to maintaining focus and equanimity.

By: Paula Cohen

Paula Cohen — Tue, 20 Oct 2009 20:49:22 +0000

Re: annoying cell phones, in spite of sign-off requests

You would think someone would come out with a cell-phone-signal scrambler for use in medical offices, classrooms, and the like. Maybe someone has…

By: paged

paged — Tue, 20 Oct 2009 19:47:18 +0000

The pager is the absolute worst interrupter of all…and this is especially obvious for medical trainees. When I was an intern, I remember 2 things clearly:
1. The residents and attendings seemed to have godlike memories and intellects.
2. My co-interns breaking down when paged to death (one liked to shout “can I please finish just one F***ing thought?”).

…and then I became a resident and all of a sudden, the page volume decreased. It became even better as an attending. Suddenly I realized why residents and attendings seemed so smart: it was the lack of pages. Sure, experience plays a big role, but just being able to complete a thought or a task before the next interruption adds dozens of effective IQ points.

Kurt Vonnegut once wrote a story about a society that made everybody equal: pretty people had to wear ugly masks, strong people had to carry around heavy weights, etc…

Guess what this society gave smart people to make them dumber. They had devices installed in their ears that would ring every so often (the smarter, the more often the interruption). Nice parable for the pager!

By: Michael Kirsch, M.D.

Michael Kirsch, M.D. — Tue, 20 Oct 2009 12:31:34 +0000

This is not purely a medical phenomenon. Interruptions are now part of the fabric of daily life. Public Enemy #1 is the cell phone, which is an omnipresent and potent mood shatterer. It intrudes on family dinners, romantic restaurant dinners, car rides with the kids, lectures and in the work place. In our exam rooms, it’s often the patients’ phones that are ringing. It’s tougher than ever to find a quiet sanctuary, but I try.